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Constructing Wholeness in LGBTQ+ Healthcare Access: A Grounded Theory Model
Braveheart Gillani1, Jessamyn Moxie2, Meagan Ray-Novak3
1College of Health and Human Services, School of Social Work, Violence Prevention Center, University of North Carolina, Charlotte, NC 28223, USA.
Healthcare (Basel, Switzerland)
|February 27, 2026
Summary
LGBTQ+ individuals construct wholeness in healthcare through internal processes like self-discovery and community support, despite facing systemic barriers. This emergent theory emphasizes identity integration and meaning-making for affirming LGBTQ+ health.
Area of Science:
- Health Services Research
- Qualitative Health Research
- Sociology of Health
Background:
- LGBTQ+ individuals face significant barriers to affirming healthcare, including discrimination and structural inequities.
- Provider limitations further exacerbate challenges in accessing appropriate care.
- This study addresses the need for a deeper understanding of how LGBTQ+ individuals build a sense of wholeness within healthcare settings.
Purpose of the Study:
- To develop an emergent grounded theory model of constructing wholeness in healthcare for LGBTQ+ individuals.
- To explore the dynamic interplay between external healthcare system forces and internal processes facilitating wholeness.
- To inform healthcare approaches that affirm LGBTQ+ identity and well-being.
Main Methods:
- Secondary analysis of qualitative data from The Rainbow Connections Study using constructivist grounded theory.
- Eight group model-building sessions conducted via Zoom with 28 LGBTQ+ participants and community center staff.
- Rigorous analysis involving open, axial, and selective coding, constant comparative methods, reflexive memoing, and member checking.
Main Results:
- LGBTQ+ individuals navigate healthcare systems where external forces can fragment or support their sense of self.
- Four interconnected internal processes—interconnecting selves, intra-community support, self-determined care, and meaning-finding—facilitate movement toward wholeness.
- These non-linear, iterative processes were observed across diverse LGBTQ+ identities and life stages.
Conclusions:
- Healthcare experiences for LGBTQ+ individuals encompass identity integration, community reliance, and meaning-making, extending beyond mere access.
- Affirming LGBTQ+ health necessitates healthcare models that promote wholeness and reduce structural harm.
- Recognizing the crucial role of community support is essential for effective LGBTQ+ healthcare navigation.
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